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Rosacea Treatment

Erythromycin 250mg Tablets
Pack Size: 168 tablets (6 weeks supply)
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Take TWO tablets TWICE daily for 6 - 12 weeks.

Erythromycin can be taken with or without food.

If you forget to take a dose take it as soon as you remember, unless it is nearly time for your next dose. In this case leave out the missed dose and just take your next dose as usual. Do not take a double dose to make up for a missed dose.

Erythromycin 250mg tablets are used to help to kill the bacteria that are thought to live on the skin and cause rosacea. Erythromycin should be taken as a six week course to treat rosacea. You should finish the course even if you think your rosacea has cleared up. If your rosacea has not fully cleared up by the end of the six week course, another six week course can be taken. If there is no effect after a twelve weeks, another treatment, such as Mirvaso or Rozex, should be tried or you should seek further advice forom your doctor.

Erythromycin tablets are suitable for people suffering with rosacea that have already tried at least one topical treatment without success.

All medicines have the potential to cause side effects however most people will not experience any of the following:

  • Nausea and vomiting.
  • Abdominal pain.
  • Diarrhoea.
  • Allergic skin reactions, such as rashes, hives or itching.
  • Disturbances of liver function.
  • Inflammation of the liver (hepatitis).
  • Yellowing of the skin and eyes (jaundice).
  • Inflammation of the pancreas (pancreatitis).
  • Reversible hearing loss (usually only after large doses).
  • Abnormal heart beats (arrhythmias).
  • Inflammation of the large intestine (colitis).

If you do experience any of these unwanted side effects you should speak to your doctor or contact us for advice.

Prolonged treatment with antibiotics can sometimes cause overgrowth of other micro-organisms and can result in vaginal thrush in some women.

Always fully read the patient information leaflet with your medicine before taking Erythromycin tablets.

Unless your doctor tells you otherwise, it is important that you finish the prescribed course of this erythromycin, even if your rosacea appears to have cleared up. Stopping the course early increases the chance that it will come back and that the bacteria will grow resistant to the antibiotic.

Broad-spectrum antibiotics, like erythromycin, can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea that becomes severe or persistent or contains blood or mucus, either during or after taking this medicine, you should consult your doctor immediately.

Erythromycin tablets should not be taken during pregnancy or breastfeeding unless under strict supervision by your doctor.

If you suffer with any of the following medical conditions you should not purchase Erythromycin online as they may not be safe to take:

  • Decreased liver function.
  • Severely decreased kidney function.
  • Abnormal heart rhythm seen on a heart monitoring trace (ECG) as a 'prolonged QT interval', or people at risk of this (your doctor will know).
  • Abnormal muscle weakness (myasthenia gravis).
  • Hereditary blood disorders called porphyrias.

 If you are taking any of the following medicines you should not buy Erythromycin tablets online as they may interact with your current medicines:

  • Warfarin (thins the blood)
  • Cisapride (used for stomach disorders)
  • Pimozide (used in the treatment of psychiatric disorders)
  • Clarithromycin (antibiotic used to treat certain infections)
  • Ergotamine or dihydroergotamine (for migraine)
  • Zopiclone (induces sleep)
  • Theophylline (helps breathing)
  • Lovastatin (blood cholesterol lowering drugs)
  • Alfentanil
  • Bromocriptine
  • Carbamazepine
  • Cyclosporin
  • Digoxin
  • Disopyramide
  • Hexobarbitone
  • Midazolam or Triazolam
  • Phenytoin
  • Quinidine
  • Tacrolimus
  • Valproate
  • Simvastatin
  • Tolterodine
  • Mizolastine
  • Amisulpride
  • Terfenadine
  • Astemizole
Mirvaso Gel
Pack Size: 30g
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RRP*: £55.00
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Our Price: £52.00
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How to apply Mirvaso Gel

  • Mirvaso Gel is applied ONCE daily, at any time of day, for as long as facial erythema (redness) is present.
  • Apply a pea sized amount to the forehead, nose, chin and cheeks.
  • Spead smoothly and evenly as a thin layer across the entire area avoiding the eyes, eyelids, lips, mouth and membrane of the inner nose. Mirvaso should only be applied over the face.
  • Wash your hands immediately after applying. 
  • The maximum daily recommended dose is 1g in total weight (five pea sized amounts)

Mirvaso can be used in conjunction with other gels and creams for the treatment of rosacea (such as Rozex). It can also be used with make up and cosmetics. They should only be used after the applied Mirvaso has dried into your skin.

Mirvaso Gel is available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat rosacea. To find out more about rosacea and see all the available treatments, see our Online Doctor Rosacea page.

The active ingredient in Mirvaso gel, Brimonidine Tartrate, belongs to a group of medicines called alpha agonists. These medicines work by stimulating the alpha receptors found in the muscle walls of the blood vessels. When applied topically it causes these blood vessels to contract. This decreases the flow of blood through the vessels, resulting in the reduction of redness.

Mirvaso gel works on a daily basis to reduce facial flushing and redness. If you forget to apply on any given day then the redness for that day will not be reduced. You should not apply double the amount the following day to compensate.

Mirvaso gel is a prescription-only-medicine (POM) that is mainly used to treat the skin condition, rosacea. It contains the active ingredient Brimonidine Tartrate in a 0.33% strength. This means that every gram of Mirvaso gel contains 3.3mg of the active ingredient. Brimonidine Tartrate belongs to a group of medicines called alpha agonists. Mirvaso gel in manufactured by Galderma and comes in a 30g tube. Each tube is accompanied by a comprehensive patient information leaflet. Mirvaso gel is for external use only.

Rosacea is a chronic condition characterised by recurrent episodes of facial flushing, redness and spots. The areas of the face commonly affected are the cheeks, nose, forehead and chin. Rosacea occurs when the blood flow to the facial skin increases. This is due to the small blood vessels in the skin dilating (widening), allowing for an increase in blood flow.

Like all medicines, Mirvaso can cause side effects, although not everybody gets them. Side effects that are considered to be common include:

  • Redness
  • Itching
  • Flushing
  • Skin burning sensation

They are typically mild to moderate in severity, and usually do not require Mirvaso use to be stopped. These side effects can feel like a worsening of your initial symptoms, and it is impossible to predict if you will experience them before you try Mirvaso. For this reason, we recommend that you order just one tube to start with, and use the gel on a small area of the face at first. Unfortunately we are not able to offer a refund for the product if you experience this common and documented side effect.

Less common side effects experienced when using Mirvaso gel include:

  • Acne
  • Dry mouth
  • Feeling cold in hands and feet
  • Feeling hot
  • Headache
  • Nasal congestion
  • Skin rash, skin pain or discomfort, skin irritation or inflammation, dry skin, warm skin sensation, tingling or sensation of pins and needles
  • Swelling of the eyelid or face
  • Urticaria (itching)
  • Worsening of rosacea

Always ensure you read the patient information leaflet enclosed with Mirvaso before using the gel.

  • Keep out of the reach and sight of children.
  • Not to be used in children less than 18 years.
  • Do not use if you are allergic to any of the listed ingredients.
  • Do not apply to closed eyes.
  • Mirvaso has not been studied in patients with renal or hepatic impairment.
  • Mirvaso should not be used during pregnancy or breast feeding.

Mirvaso is not suitable for use if you suffer with any of the following conditions:

  • The skin of your face is irritated or has open wounds.
  • You have problems with your heart or circulation.
  • You have depression, decreased blood flow to the brain or the heart, fall in blood pressure on standing up, decreased blood flow to the hands, feet or skin, or Sjögren’s syndrome (a chronic disease in which the body’s natural defence - the immune system - attacks the moisture-producing glands).
  • You have kidney or liver problems or have had them in the past.

Mirvaso is not suitable for use if you take any of the following:

  • Medicines used for depression or Parkinson’s disease including so?called monoamine oxidase (MAO) inhibitors (for example selegiline or moclobemide)
  • Tricyclic antidepressants (such as imipramine) or tetracyclic antidepressants (such as maprotiline, mianserin or mirtazapin).
  • Medicines used for the treatment of pain, sleep disorders, or anxiety disorders.
  • Medicines used for the treatment of psychiatric disorders (chlorpromazine) or used for hyperactivity (methylphenidate) or used for high blood pressure (reserpine).
  • Medicines which act on the same body mechanism as Mirvaso (other alpha agonists, e.g. clonidine; so?called alpha blockers or alpha antagonists, e.g. prazosin, isoprenaline which are most often used for treatment of high blood pressure, slow heart rate or asthma).
  • Cardiac glycosides (e.g. digoxin), used to treat heart problems.
  • Blood pressure lowering medicines such as beta-blockers or calcium channel blockers (e.g. propranolol, amlodipine).
Rozex 0.75% Gel
Pack Size: 40g
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Our Price: £22.50
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How to apply Rozex Gel

  • First wash and dry the affected areas of your skin.
  • Apply a thin layer of the gel to all the affected areas. Rub the gel well in.
  • Always replace the cap and wash your hands after use.
  • Rozex gel should be used in this way twice a day, morning and evening.

Rozex gel should be used for three to four months to help clear up rosacea. If your rosacea has not fully cleared up in this time, another three to four month treatment can be undertaken. 

You should always use Rozex gel for a minimum of three months to ensure you see the full effect.

Rozex 0.75% Gel is available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help to treat rosacea. To find out more about rosacea and see all the available treatments, see our Online Doctor Rosacea page.

Rozex Gel contains the active ingredient Metronidazole in a strength of 0.75%. It is mainly used to treat the condition Rosacea. Rozex Gel is classified as a prescription-only-medicine (POM) and is manufactured by Galderma. The 40g tube of gel is accompanied by a comprehensive patient information leaflet (PIL).

Rozex Gel is applied topically to the skin to treat the condition Rosacea. Rosacea is a chronic condition caused by inflammation. This usually occurs on the cheeks, nose, forehead, chin and eyelids. It can result in acne-like outbreaks or increased redness in these areas of the face. Rozex Gel is believed to reduce this inflammation and redness by controlling any infection present on the skin, thus reducing skin irritation.

Once you start using Rozex Gel, it will usually take two to three months for the skin to become clear from spots. Even if the results are not immediate it is recommended to persevere with the prescribed treatment. It isn’t usually recommended to use Rozex Gel for longer than a four month period unless otherwise advised to by your doctor.

Metronidazole (the active ingredient in Rozex) belongs to a group of medicines called nitroimidazole antibiotics. It is used to treat infections caused by bacteria and other micro-organisms called protozoa. It effectively eliminates these micro-organisms by damaging their genetic material (DNA). This means the bacteria and protozoa are unable to produce any new genetic material, making them unable to multiply.

Like al medicines, Rozex can cause side effects which are most likely to occur at the start of treatment. Most side effects last for less than a week and are mild. If you require any further advice please refer to your Patient Information Leaflet or contact one of our medical team. 

Common side effects of Rozex Gel can include:

  • dry skin
  • redness of the skin (erythema)
  • itching of the skin (pruritus)
  • skin discomfort (burning, pain of skin / stinging)
  • skin irritation
  • worsening of rosacea

If you experience side effects when using Rozex Gel, you may wish to decrease the frequency of application to once daily initially for around seven days then build up to twice daily application. For further information on Rozex gel and it's side effects see the Patient Information Leaflet contained within your medicine.

Do not use Rozex

If you are allergic to metronidazole or any of the other ingredients of this medicine. An allergic reaction may include a rash or itching.

Warnings and precautions

Talk to your doctor or pharmacist before using Rozex.

  • Do not get the cream in your eyes. If you do, rinse thoroughly with large amounts of warm water or eye wash.
  • If you suffer from any blood disorders do not use Rozex unless your doctor says you can.
  • This product should not be used in children.
  • Do not go out into strong sunlight (including sun-bathing) and avoid exposure to ultra-violet light (eg solariums, sun-lamps) while you are using this product.
  • Avoid prolonged and unnecessary use of this medicine.

Other medicines and Rozex

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Using Rozex could interfere with drugs used to reduce blood clotting (anticoagulants) such as warfarin and dicoumarin.

Contact your doctor for advice if you are taking medicines to reduce blood clotting, or if you suffer from any other blood disorders.

Rozex with alcohol

Metronidazole taken by mouth can react with alcohol. This reaction is unlikely with Rozex Cream because it is only applied on the skin. However, you are advised not to drink alcohol while you are using Rozex Cream.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, it may not be advisable to use this product, unless your doctor considers it essential. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Rozex Cream contains cetostearyl alcohol

Cetostearyl alcohol may cause local skin reactions (e.g. contact dermatitis).

About Rosacea

Rosacea Background

Rosacea is a very common skin complaint that mainly affects the face. The condition will present as the skin becoming red for short periods, this can also referred to as flushing. Other associated symptoms can include:

  • Permanent redness
  • A burning or stinging sensation
  • Spots
  • Small blood vessels can become visible in the skin

Rosacea is a condition that is prone to relapsing. This means you will experience episodes of severe symptoms that will be followed by periods where the condition is less severe. An episode of rosacea can be triggered by numerous factors, with different people having different triggers. The most triggers are:

  • Exposure to hot or cold temperatures
  • Strong winds
  • Alcohol, caffeine and hot drinks
  • Spicy food and dairy products
  • Sunlight exposure
  • Stress
  • Humidity
  • The menopause

It isn’t fully understood what exactly causes rosacea. There are a number of possible factors that have been suggested. It is believed by some experts that rosacea is caused by a blood vessel abnormality. However, what causes this particular abnormality is still unknown.

More recent research has suggested that the external triggers of rosacea can lead to the activation of molecules in the skin known as peptides. Having excess levels of peptides in the skin can activate both the immune and neurovascular systems of the skin. This activation can cause the blood vessels to dilate, resulting in redness and inflammation.

Another possible cause are microscopic mites called demodex folliculorum. These mite usually reside harmlessly on human skin. Sufferers of rosacea present with higher numbers of these mites and research suggests rosacea can be caused by the skin’s reaction to the bacteria found in the mite’s faeces.

Alternatively, a current theory suggests that a bacteria found in the digestive system, helicobacter pylori bacteria, is the cause of rosacea. This theory argues that helicobacter pylori stimulates the production of a protein called bradykinin. This protein is known to cause blood vessels to expand and hence cause the effects of rosacea.

It is apparent that rosacea is more common in families. This could suggest a genetic cause of the condition. However, it is not clear which genes are involved or how the condition is passed on.

Rosacea Symptoms

The main and most common symptom of rosacea is facial flushing. This is characterised by the skin turning red for short periods-usually only a few minutes. This flushing will mainly affect the face but in some instances the neck and chest can be affected as well. Some sufferers experience an uncomfortable heat sensation that accompanies this skin reddening.

Some sufferers are affected by a persistent facial redness that resembles a patch of sunburn that does not subside. This form of rosacea is known as erythema and it usually affects the nose, cheeks and chin. In some cases erythema can spread to the forehead, neck and chest.

Another visible symptom of rosacea can include permanently widened blood vessels. These vessels have dilated over time and will be visible on the skin. This is known as telangiectasia.

Someone with rosacea can develop papules and pustules. A papule is a round red bump that protrudes from the skin. A pustule is a puss-filled swelling. These will mainly appear on the face and can resemble the symptoms of acne. However, rosacea and acne are unrelated conditions. Unlike acne, rosacea does not potentially damage the skin or cause any scarring.

In more severe cases of rosacea the skin can thicken, causing the sufferer to experience a build-up of excess tissue. This tissue usually forms around the nose causing it to become enlarged and bulbous. This symptom will take years to develop and is not that common. This thickening of the skin is called rhinophyma and tends to affect more men than women.

Rosacea can, in some cases, affect the eyes as well. This is known as ocular rosacea and symptoms can include; dry, irritated or bloodshot eyes, inflammation of the eyelids and feeling as though there is something in your eyes. If ocular rosacea starts to cause any pain in the eye, blurred vision or a sensitivity to light then it is recommended to seek medical advice immediately.

Other more generic symptoms associated with rosacea include:

  • Lymphoedema: A swelling of the face.
  • Rough, dry skin.
  • Sensitive skin that can include; burning, stinging, itching and pain.

Rosacea Diagnosis

Rosacea can be diagnosed by a doctor or dermatologist by a visual inspection and through questions about your symptoms and triggers.

Rosacea Treatment

Unfortunately, rosacea doesn’t have a cure. However, there are treatments available designed to keep the symptoms contained. The type of treatment will depend on what symptoms you are presenting with. If your rosacea has caused papules and pustules to develop then there are various different treatments that can be effective.

The first line of treatment will usually be a topical gel or cream. The two topical treatments most often prescribed are Metronidazole (Rozex Gel) and Azelaic Acid (Skinoren Cream). Treatments such as Skinoren and Rozex are usually applied once or twice daily to the affected area. If Skinoren and Rozex have proved ineffective then a course of oral antibiotics may be necessary. Antibiotics used to treat rosacea include Tetracycline, Oxytetracycline and Erythromycin. These courses usually last for four to six weeks, depending on the persistence of the spots.

Treating facial redness in rosacea can prove more difficult to treat than papules and pustules. Brimonidine Tartrate (Mirvaso Gel) is a topical gel treatment that works by restricting the dilation of the blood vessels in the face. Research shows it can have an effect in as little as 30 minutes after application. Once applied the effects of Mirvaso Gel can last for up to twelve hours.

Treating thickened skin (rhinophyma) will require referral to a dermatologist or plastic surgeon. There are a number of surgical treatments available that can remove the excess tissue from the nose.

Treating ocular rosacea may require lubricating eye drops or oral antibiotics from your GP. If these prove ineffective then you will need to be referred to an ophthalmologist for further testing and treatment.

Rosacea Prevention

There are a number of self-help techniques that can help contain the symptoms of rosacea. These involve:

  • Avoiding known triggers: For example, if you know hot baths trigger your rosacea then try reducing the water’s temperature or have a cooler shower instead. If sunlight makes your symptoms worse then reduce exposure by covering the skin or by using a sensitive, high SPF sunscreen. Stress is a very common trigger of rosacea. By managing your stress levels you can help reduce the chance of an outbreak.
  • Looking after your skin: Cleanse and moisturise your skin using non-irritant, hypoallergenic products designed for sensitive skin. It is recommended to avoid astringent toners and products that contain ingredients that can cause irritation to the skin. Known irritants include; fragrances, alcohol, menthol, lanolin, clove oil, witch hazel, eucalyptus oil, sodium lauryl sulphate and camphor. For men, switching to an electric razor has been shown to reduce skin irritation.
  • Using camouflage make-up: If suffering with persistent red skin then using suitable make-up products will help to conceal these patches. Your GP or specialist can refer you to a skin camouflage service or directly prescribe skin camouflage products.
  • Keeping your eye lids clean: If rosacea is known to affect you eyelids then ensure they are kept clean. This will help reduce any inflammation or irritation. If using eye make-up, it is recommended to select a product that is mild and washes off easily.

*RRP is based on the highest price found for a comparable online service found on 04/09/14.

Rosacea Frequently Asked Questions

Rozex Gel & Skinoren Cream

How often do I apply Rozex Gel or Skinoren Cream?

Topical antibiotic medication such as metronidazole (Rozex Gel) applied one to two times a day after cleansing may significantly improve rosacea. Azelaic acid (Skinoren Cream 15%) is another effective treatment for patients with rosacea. Both active ingredients control the redness and bumps asscoiated with rosacea.

What do I do if I miss a dose?

Although these topical appllication works best if you use it regularly as directed, don’t worry if you forget to use your gel at the right time.
When you do remember, start using it again in the same way as before.

Can I drink alcohol when using Rozex or Skinoren?

Skinoren is not effected by alcohol.

Alchol should not be taken with metroniadazole tablets as it can cause nausea and vomitting. The reaction is unlikely with topical application but the manufacturer advises it is best avoided.


Erythromycin Tablets

How often do I take antibiotic tablets for rosacea?

Take two tablets twice a day

Do I have to take these with or after food?

Erythromycin can be taken with food or on an empty stomach. If you find taking medication upset you then take them with food.

Will antibitoics used for rosacea treatment interfere with my contraceptive pill?

Antibiotics that interfere with the contraceptive pill are rifampicin and rifabutin. They are mainly used to treat or as preventive medictnes for tuberculosis and meningitis.

Other antibiotics are not thought to interact with the contraceptive pill.

What should I do if I forget to take a dose of ?

Take the forgotten tablet as soon as you remember. If that is not until the next dose is due. Do not take two doses to make up for the one you have missed. 

Is there a cure for rosacea?

Unfortunately, rosacea doesn’t have a cure. However, there are treatments available designed to keep the symptoms contained. The type of treatment will depend on what symptoms you are presenting with. 


If you require further information help or support you can contact our professional team of doctors and pharmacists via

Tel 0117 9711603
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The Independent Pharmacy is an online pharmacy and online doctor service is owned and operated by ABSM Healthcare Ltd (Company Reg. 08515600) and Red Label Medical Ltd (Company Reg. 08676338). All information that appears on this website is intended for information purposes only and should be used to supplement, not replace, your relationship with your local healthcare professionals. You should consult your doctor if you think you may have a health problem or before you start taking a new medicine. Please ensure you always read the information leaflets supplied with any medicinal products.For more information see our policies and terms and conditions at the bottom of every page. © 2014 ABSM Healthcare Ltd. All rights reserved.
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